Radical cavities resulting from open tympanoplasty performed for chronic cholesteatomatous otitis may lead to postoperative complications and negatively affect patients' quality of life. These cavities can remain unstable and may be associated with persistent otorrhea, limitations in the use of hearing aids, and the need to avoid water exposure, all of which may significantly impact daily activities. Although mastoid and paratympanic cavity obliteration techniques are increasingly used during primary surgery, many patients previously treated with open tympanoplasty continue to present with problematic postoperative cavities. Obliteration procedures have been proposed in revision surgery to improve cavity stability and reduce complications. Bioactive glass S53P4 has recently attracted interest as an obliterative material due to its long-term stability, biocompatibility, antibacterial properties, and ability to integrate with surrounding tissues. However, evidence regarding the medium-term clinical outcomes of this approach remains limited. The aim of this study is to evaluate the clinical effectiveness and safety of mastoid cavity obliteration using bioactive glass S53P4 in patients with radical cavities following open tympanoplasty. The study will assess surgical success, complication rates, and the impact of the procedure on patient quality of life.
Study Type
OBSERVATIONAL
Enrollment
50
Surgical obliteration of symptomatic radical mastoid cavities using S53P4 bioactive glass as obliterative material during revision surgery after previous open tympanoplasty.
Trial Office
Legnano, Italy, Italy
Quality of Life Improvement After Mastoid Cavity Obliteration With S53P4
Change in quality of life assessed using the Chronic Otitis Media Questionnaire-12 (COMQ-12). The COMQ-12 is a validated questionnaire with total scores ranging from 0 to 60, where higher scores indicate worse quality of life and greater disease severity. The outcome is defined as the mean change in total COMQ-12 score from preoperative assessment to postoperative follow-up. Unit of measure: Points (COMQ-12 score).
Time frame: 3 months after surgery
Change in quality of life (GBI score)
Change in quality of life assessed using the Glasgow Benefit Inventory (GBI), a validated questionnaire with scores ranging from -100 to +100, where higher scores indicate greater benefit. The outcome is defined as the mean postoperative GBI total score. Unit of Measure: Points (GBI score)
Time frame: 3 months after surgery
Change in audiometric hearing thresholds
Change from baseline in audiometric hearing thresholds measured by pure-tone audiometry. The outcome is defined as the mean change in hearing threshold levels between preoperative and postoperative assessments. Unit of Measure: Decibels (dB)
Time frame: 3 months after surgery
Resolution of otorrhea
Resolution or improvement of otorrhea assessed clinically and defined as absence of ear discharge at follow-up. Unit of Measure: Percentage of participants
Time frame: 3 months after surgery
External auditory canal condition
Condition of the external auditory canal assessed by otoscopy and graded using the Merchant scale, with the objective of achieving a dry ear. Unit of Measure: Merchant scale score from 0 to 4, where 0 indicates no vertigo and 4 indicates severe vertigo with significant disability.
Time frame: 3 months after surgery
Change in cavity volume
Change in cavity volume measured using water filling of the ear canal. The outcome is defined as the difference between preoperative and postoperative cavity volume. Unit of Measure: Milliliters (mL)
Time frame: 3 months after surgery
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